Increased periodontal pathology in Parkinson's disease

Parkinson's disease is characterized by rigidity, akinesia and tremor, all of which interfere with automated small hand movements potentially affecting oral care. In addition, medication and craving for sweets are other risk factors for dental and periodontal disease in these patients. Here, we report the Community Periodontal Index for Treatment Needs (CPITN) data in 70 patients with Parkinson's disease and 85 age-matched control subjects. CPITN indices were assessed in all 6 sextants. Mean CPITN indices of control subjects ranged from 1.6 +/- 0.2 in the upper frontal sextant to 2.5 +/- 0.2 in the upper left lateral sextant. 17.9% of controls showed severely affected teeth (CPITN code 4) in the upper left or upper right sextant, while there were no teeth at risk in the upper frontal sextant. Patients suffering from Parkinson's disease, however, had a markedly increased mean CPITN index in the upper frontal sextant (2.4 +/- 0.2) with 11.5 patients having severely affected teeth (CPITN code 4). CPITN indices in all other sextants were less severely increased. Overall, there was a significant difference between mean CPITN indices of patients and controls (p < 0.05). It seems also noteworthy that female controls had lower CPITN indices in all sextants compared with male controls. This gender difference, however, was reversed in Parkinson's patients. We believe that problems in oral hygiene contribute to this increased periodontal pathology in patients with Parkinson's disease, which may further compromise the quality of life.